Evaluating Outcomes for Women with Metastatic Breast Cancer: Palliative Care Consultations, Hospital Charges, and Length of Stay.

Simple Summary: Metastatic breast cancer (MBC) frequently results in increased pain and distress for women affected by the disease. Management of these symptoms can be complicated and expensive, leading to undue stress for these patients and their families. Palliative care has demonstrated effectiveness in alleviating symptomology due to disease and improving quality of life for patients with MBC, yet utilization of palliative care remains low. The purpose of this study is to document the prevalence of palliative care consultations among inpatients with metastatic breast cancer and to examine the impact of palliative care on the length of hospital stay and total hospital charges. The results of this study demonstrate that only 5.7% of patients with metastatic breast cancer received a palliative care consultation during their inpatient stay. Palliative care consultation was associated with a longer length of stay but lower hospital charges. Introduction: Women with late-stage metastatic breast cancer are at an increased risk of pain and distress from symptoms and often struggle with associated emotional and financial burden of their disease. Palliative care is known to alleviate symptom burden in patients with end-stage, terminal diseases but is often underutilized in both inpatient and outpatient settings. The current study aims to investigate the prevalence of palliative care consultation on inpatients with metastatic breast cancer and examine the association between palliative care consultation and length of hospital stay and total hospital charges. Methods: Patients diagnosed with metastatic breast cancer between 1998–2017 were abstracted from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Database (NIS). The primary outcome was the presence of a palliative care consultation (PCC) during the inpatient stay. Secondary outcomes were hospital length of stay and total hospital charges. Multivariable logistic regression was used to examine factors associated with the presence of a PCC. The relationship between PCC and hospital length of stay and total hospital charges were investigated using linear regression. Results: 513,509 cases of metastatic breast cancer were identified, 5.7% had a documented in-hospital palliative care encounter. Of those who received PCC, total hospital charges were about USD 5452 less than those who did not receive consultation. Women who received PCC had higher odds of a longer hospital stay. Predictors of PCC were older age, non-White race, and residing in a lower-income ZIP code. Conclusions: Palliative care remains to be an underutilized resource among patients with end-stage metastatic breast cancer. [ABSTRACT FROM AUTHOR]